Sam Tyano, the former director of the Geha Psychiatric Hospital in Petah Tikva, Israel, gave evidence on Leifer's mental state at Tuesday's closed hearing in Jerusalem District Court.

Dr Tyano stirred controversy in 2011 after claiming in a book on mental health that homosexuality is a symptom of an emotional disorder and psychotherapy is the cure.

In 2017, when father Nadav Sela killed his wife and two children in Israel, Dr Tyano testified Sela was instructed by God to murder them.

Dr Tyano's testimony to the court will help decide whether Leifer is fit to be extradited to Australia to face 74 charges of rape and child sex abuse.

The charges stem from Leifer's time as principal at the ultra-orthodox Adass Israel school in Melbourne.

Three sisters who attended the Adass school, Elly Sapper, Dassi Erlich and Nicole Meyer, have been fighting to have her extradited since 2011.

As the extradition trial continues to be strung out over the defence's claims Leifer is mentally unfit to appear in court or face trial in Australia, the Melbourne sisters expressed their frustration.

"Another hearing, another psychiatrist, 49 court dates! How many more questionable characters will take the stand in defence of Malka Leifer?" the sisters said in a statement to AAP.

"When will it be our turn to have our voice heard?"

Just two weeks ago, the defence called Brian Tappler to present a psychiatric assessment, the integrity of which has also been questioned.

Dr Tappler had previously announced on Facebook Leifer was innocent of her charges and stated those accusing her were not "frum", or devout Jews.

The next extradition hearing is set for April 15.

Australian Associated Press